Caring for Patients from Different Cultures

Caring for Patients from Different Cultures

Geri-Ann Galanti
Copyright Date: 2015
Edition: 5
Pages: 384
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  • Book Info
    Caring for Patients from Different Cultures
    Book Description:

    Healthcare providers in the American medical system may find that patients from different cultures bring unfamiliar expectations, anxieties, and needs into the examination room. To provide optimal care for all patients, it is important to see differences from the patient's perspective and to work with patients from a range of demographics.Caring for Patients from Different Cultureshas been a vital resource for nurses and physicians for more than twenty years, offering hundreds of case studies that illustrate crosscultural conflicts or misunderstandings as well as examples of culturally competent health care.

    Now in its fifth edition,Caring for Patients from Different Culturescovers a wide range of topics, including birth, end of life, communication, traditional medicine, mental health, pain, religion, and multicultural staff challenges. This edition includes more than sixty new cases with an expanded appendix, introduces a new chapter on improving adherence, and updates the concluding chapter with examples of changes various hospitals have made to accommodate cultural differences. Grounded in concepts from the fields of cultural diversity and medical anthropology,Caring for Patients from Different Culturesprovides healthcare workers with a frame of reference for understanding cultural differences and sound alternatives for providing the best possible care to multicultural communities.

    eISBN: 978-0-8122-9027-1
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Preface to the Fifth Edition
    (pp. ix-xiv)
  4. Acknowledgments
    (pp. xv-xvi)
  5. Chapter 1 Basic Concepts
    (pp. 1-33)

    If the United States is a melting pot, the cultural stew still has a lot of lumps.

    What happens when an Iranian doctor and a Filipino nurse treat a Mexican patient? When a Navajo patient calls a medicine man to the hospital? Or when an Anglo nurse refuses to take orders from a Japanese doctor? Generally, the result is confusion and conflict, unless they all have some understanding of cultural differences.

    The goal of the medical system is to provide optimal care for all patients. In a multiethnic society, this goal can be accomplished only if the health care providers...

  6. Chapter 2 Communication and Time Orientation
    (pp. 34-63)

    Miscommunication is a frequent problem in hospitals. The most obvious case is when the patient and the hospital personnel do not speak the same language. Although interpreters should always be available, either in person or by telephone, they are not always used. Bilingual family members may not possess the necessary vocabulary, or have their own agendas. There are also more subtle problems that result from cultural differences in verbal and nonverbal communication styles and patterns. This chapter explores these problems in communication as well as another subtle but provocative source of difficulty—cultural differences in time orientation. Patients and staff...

  7. Chapter 3 Pain
    (pp. 64-75)

    An important health care issue is the treatment of pain. Untreated pain can interfere with the healing process, both by reducing the amount of movement that is comfortable for the patient and by compromising the immune system. Before it can be treated, however, it must be properly assessed. This can cause confusion for health care providers who are unaware of cultural differences in response to pain, particularly in how it is expressed. Some patients come from cultures that encourage emotional expressiveness. Others come from cultures in which stoicism is valued, thus masking any visual signs of pain patients might be...

  8. Chapter 4 Religion and Spirituality
    (pp. 76-95)

    Religion is rarely a topic of conversation in hospitals, but religious beliefs and spiritual practices are common sources of conflict and misunderstanding. Patients’ exercise of their beliefs can sometimes result in interference with medical care. This chapter examines religious and spiritual beliefs that can create conflicts, misunderstandings, or worse. It also looks at several cases where a culturally competent approach on the part of health care providers made a positive difference for patients.

    A twenty-year-old Buddhist monk from Cambodia was in same-day surgery for a hernia repair, accompanied by his mother, aunt, and male cousin. When Lisa, his nurse, entered...

  9. Chapter 5 Activities of Daily Living and the Body
    (pp. 96-110)

    There are some basic activities that patients must perform each day, including eating, bathing, using the bathroom, and caring for their hair. Not surprisingly, these activities are influenced by culture and thus a potential source of conflict in the hospital. A second topic concerns the concept of body image. The ideal image varies considerably from culture to culture and may affect patients’ attitudes toward specific treatments.

    Dietary practices are an important issue for hospitals. Patients who do not eat are often a cause of concern for physicians and nurses. Is there a gastrointestinal problem? Is the patient suffering from depression?...

  10. Chapter 6 Family
    (pp. 111-128)

    When asked to name their most common problem in dealing with non-Anglo ethnic groups, most nurses respond, “their families.” This is understandable, given cultural differences in a number of issues related to family, including decision-making and the role of family members when someone is ill. However, the application of cultural sensitivity can make the hospital experience less stressful for patients, family members,andhealth care providers.

    In U.S. culture theindividualis the primary unit, and autonomy and independence are highly valued. As such, we expect individuals to make their own decisions regarding health care, as long as they are...

  11. Chapter 7 Men and Women
    (pp. 129-145)

    Sex and gender are frequent sources of conflict and misunderstanding. Not every culture has been affected by the women’s movement. Few share the American ideal of equality between the sexes.

    Since the advent of the women’s movement in the 1970s, a concerted effort has been made to eliminate restrictive sex roles. Rather than having opportunities limited by one’s sex, the emphasis is on treating each person as an individual and allowing free expression of their abilities. Admittedly, that is an idealized version of what is happening, but it reflects our cultural ideology and the direction in which we are trying...

  12. Chapter 8 Staff Relations
    (pp. 146-172)

    Not only is the patient population culturally diverse, the staff population is as well. In addition to Anglo staff, hospitals frequently have large populations of doctors from Asia and the Middle East, nurses from the Philippines and Mexico, and orderlies from a variety of countries. This chapter addresses some of the problems and misunderstandings that can occur when hospital staff members from diverse cultural backgrounds interact, or as a result of differences in training.

    Problems frequently stem from the differing status of both women and nurses in the United States and other countries. In many countries, particularly those of the...

  13. Chapter 9 Birth
    (pp. 173-193)

    Increasingly, people enter the world in a hospital. Birth is an emotional and generally painful occasion imbued with cultural ritual and thus, once again, we find the potential for misunderstanding and conflict, as well as opportunities for cultural sensitivity.

    A classic anthropological theory, formulated by Bronislaw Malinowski, states that under conditions of chance or uncertainty, when things cannot be controlled by knowledge, people will turn to magic. Pregnancy certainly fits that condition, and thus it is not surprising that there are numerous beliefs regarding what one should and should not do during pregnancy. One of the most common taboos involves...

  14. Chapter 10 End of Life
    (pp. 194-212)

    In the past most people died at home, cared for by their families. Today, however, people are dying more frequently in hospitals, cared for by professionals. Thanks to improved medical technology, people are also taking longer to die. The end of life is often fraught with difficulties for patients and their families. In addition, there are complications that can occur because cultural traditions vary significantly on a variety of issues, including whether or not to reveal the diagnosis to the patient, attitudes toward removing life support, expression of grief at the time of death, attitudes toward organ donations and autopsies,...

  15. Chapter 11 Mental Health
    (pp. 213-223)

    The mental health profession is paying increasing attention to the effect of culture on individual psychology. Many graduate programs in clinical psychology now offer courses on treating clients from culturally diverse backgrounds. Knowledge of the range of what is considered “normal” is essential to effectively treating both private practice clients and hospital patients. Unfortunately, psychiatric diagnoses of foreign patients can be inaccurate, due to health care workers’ ignorance of cultural patterns. This chapter will address some issues that relate to the mental health of patients.

    One definition of mental illness is behavior that deviates significantly from the norm. Because each...

  16. Chapter 12 Traditional Medicine: Practices and Perspectives
    (pp. 224-251)

    People have been healing the sick long before the advent of biomedicine. Neanderthal burials from 65,000 years ago show evidence of healed wounds and the presence of plant pollen from species known to have healing properties. Even chimpanzees—our closest living relatives—have been observed chewing a particular species of leaf that appears to expel some sort of tapeworm.

    Many people grow medicinal plants in their own gardens or obtain them from a neighborhood or professional healer. These plants may be used as first aid, to treat wounds and burns, aches and pains, upper respiratory infections, earaches, and chronic conditions....

  17. Chapter 13 Improving Adherence
    (pp. 252-260)

    A common problem referred to throughout this book is lack of adherence. According to the World Health Organization, 50 percent of patients in developed countries with chronic diseases do not adhere to treatment recommendations (WHO 2003). And as Surgeon General C. Everett Koop famously put it, “Drugs don’t work in patients who don’t take them.” As a side note, the WHO prefers the term “adherence” to the more commonly used “compliance.” Adherence assumes patient-centered care—that the patient is “sticking to” the treatment plan created with the clinician. Compliance assumes more paternalistic care—that the patient is following the orders...

  18. Chapter 14 Making a Difference
    (pp. 261-274)

    In addition to looking at the ways in which cultural differences can lead to conflict and misunderstanding, this book has emphasized the things clinicians can do to provide more culturally sensitive care for their patients. Individual doctors and nurses can make a big difference, as will be demonstrated, but for cultural competence to become an integral part of health care, hospitals and clinics must make changes as well. I’m delighted to report that many already are. In this chapter, I want to focus on some of the things various hospitals and clinics are doing to provide more culturally sensitive care,...

  19. Appendix 1. Cultural Profiles
    (pp. 275-297)
  20. Appendix 2. Selected Religions
    (pp. 298-304)
  21. Appendix 3. Dos and Don’ts of Providing Culturally Competent Care
    (pp. 305-307)
  22. Appendix 4. Tips for Working with Interpreters
    (pp. 308-309)
  23. Appendix 5. Summary of Case Studies
    (pp. 310-338)
  24. Bibliography
    (pp. 339-354)
  25. Index
    (pp. 355-368)